Healthy Life Project - Reducing the Burden of Non-Communicable Diseases in Moldova

Project Abstract

BackgroundNon-communicable diseases (NCDs) are the leading cause of death worldwide. Like many countries, the Republic of Moldova faces a growing NCD mortality and morbidity burden: more than half of the population suffers from non-communicable diseases, including cardiovascular diseases, cancer, chronic respiratory diseases, digestive diseases and diabetes.In January 2017, the Government of the Republic of Moldova and the Swiss Agency for Development and Cooperation (SDC), within the framework of international cooperation, signed a Memorandum of Understanding on the “Healthy Life project: Reducing the Burden of Non-Communicable Diseases in Moldova” which is implemented by Swiss TPH.

Objectives and AimThe overall goal of the Healthy Life project is to contribute to the improvement of the health status of the Moldovan population, especially in rural areas, through the reduction of the burden of non-communicable diseases.

The project outcomes are: Outcome 1: National health authorities create an enabling policy environment for decentralized and integrated management of NCDs. Healthy Life works with partners to identify, establish or harmonise laws, policies, regulations and collaboration mechanisms at all levels to facilitate effective and efficient actions to reduce the burden of NCDs on people and the health system.

Outcome 2: The population in target districts has access to, and uses, quality integrated care, including outreach services, related to NCDs. Healthy Life focuses on improving the capacity and quality of NCD diagnosis, treatment and management at Primary Health Care (PHC) level, but also on the reorganisation of PHC health services towards integrated care to ensure a continuum of care for chronic patients. Capacities for preventive services, interdisciplinary work and collaboration with community and non-governmental institutions are strengthened.

Outcome 3: The population in target districts has improved its healthcare seeking behaviour and reduced its NCDs risk behaviour. Healthy Life supports multisectoral engagement in health promotion and builds capacities of rayon health teams to elaborate an evidence-based community health profile and community based health action plans addressing risk factors of NCDs among their population. In parallel, community groups are mobilised and empowered to play an active role in demanding quality healthcare services and making the health system responsive to patients’ needs.

Methods/ApproachesHealthy Life is designed to support the Moldavian Ministry of Health, Labour and Social Protection and the National Agency for Health Promotion to implement the national health reform agenda, especially in the areas of Public Health and PHC. Its approach is to facilitate the organisation of an intersectoral response to NCDs with improved health intervention planning, better collaboration and management. Models of integrated care and outreach are promoted. The project aims also to facilitate a shared understanding of evidence-based and innovative approaches to health promotion.

Results

Healthy Life is supporting the PHC reform by translating national clinical protocols for NCD into patients’ materials so far for Diabetes Type II, and Ischaemic heart disease.

A needs assessment of basic equipment that would be needed at PHC level to implement national clinical protocols has been conducted in the 10 pilot rayons with a view to supplying this equipment in close collaboration with MoHLSP.

Costing of care management of patients with NCD is being carried out with the National Health Insurance Company

Facilitating a working group to elaborate a concept for Community Nursing for the Moldovan context

Healthy Life is working with the National Agency for Public Health to facilitate intersectoral activities for health promotion at national, rayon and village level

Healthy Life has introduced the use of health profiles at rayon level and now rolling this out to community level

Target Groups

Family doctors, medical assistants and community nurses from 10 pilot rayons

National Agency for Public Health and Rayon Centres for Public Health from 10 pilot rayons

Rayon councils from 10 pilot rayons

Mayors and their multidisciplinary teams from selected communities

Patients groups and community members

Key Partner Institutions

Ministry of Health, Labour and Social Protection of the Republic of Moldova, relevant institutes and departments

Rayon and Local Public Authorities from 10 pilot rayons

Teaching and training institutions for family health teams

Selected community based organisation

World Health Organization and UN agencies

Other thematic NGOs

Other important informationHealthy Life is implemented in 10 pilot rayons which are involved in two waves: successful approaches developed in the first four rayons (Falesti, Ungheni, Stefan Voda and Cahul) are now being disseminated to the additional 6 rayons (Orhei, Criuleni, Taraclia, Vulcanesti, Edinet and Briceni). The first phase of the project covers the timeframe 01.07.2016 – 30.06.2020.Healthy Life operates through a Project Facilitation Unit based in Chisinau, Moldova.